Use of murine monoclonal antibodies for laboratory diagnosis of varicella-zoster virus infection.

The laboratory diagnosis of varicella-zoster virus (VZV) infection was reevaluated by direct immunofluorescent-antibody staining (DFA) and centrifugation culture with newly available murine monoclonal antibodies. Specimen smears were examined by DFA using monoclonal antibodies to VZV and to herpes simplex virus types 1 and 2. Specimens were also inoculated into shell vials for centrifugation culture and into standard tube cell culture. Of 68 specimens tested from 60 patients, 39 (57%) were positive for VZV by at least one method. DFA was positive in 36 of 39 (92%); centrifugation culture was positive at 24 h in 23 of 39 (59%) and at 48 h in 31 of 39 (79%); and standard culture was positive in 25 of 39 (64%). Twenty-three of the 39 positive specimens (59%) were positive by all three techniques. Forty-three of the 60 patients were considered to have VZV by clinical criteria, and 35 of these 43 (81%) had laboratory confirmation of the diagnosis. These data confirm that DFA is the method of choice for the rapid laboratory confirmation of VZV infection. The centrifugation culture assay can provide an alternative method to DFA for the laboratory diagnosis of VZV infection.